MEDICARE: INTERFAITH COMMUNITY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency		MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063500858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERFAITH COMMUNITY SERVICES, INC.

Provider Business Mailing Address
First Line	:	5400 KING HILL AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64504-1503
Country	:	US
Telephone Number	:	816-238-4511
Fax Number	:

Provider Business Practice Location Address
First Line	:	5400 KING HILL AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64504-1503
Country	:	US
Telephone Number	:	816-238-4511
Fax Number	:	816-232-7029

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	BRIDGET SUPPLE
Credential	:
Telephone Number	:	816-238-4511

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	01/12/2024

Similar Medicare Providers

1043382740 — INTERFAITH COMMUNITY SERVICES, INC.
Practice Location Address:

5400 KING HILL AVE
SAINT JOSEPH, MO
64504-1503

Practice Phone: 816-238-4511
Practice Fax: 816-232-7029

1972542124 — MRS. MARIETTE PIERRE M.D.
Practice Location Address:

1315 ST JOSEPH PKWY , SUITE 1503
HOUSTON, TX
77002-8233

Practice Phone: 713-655-0073
Practice Fax: 713-655-1332

1821199613 — JAMES D PIERRE M.D.
Practice Location Address:

1315 ST JOSEPH PKWY , STE# 1503
HOUSTON, TX
77002-8233

Practice Phone: 713-655-0073
Practice Fax: 713-655-1332

1407070477 — MICHAEL K DAVIDSON, M.D.
Practice Location Address:

1315 ST JOSEPH PKWY STE 1503
HOUSTON, TX
77002-8237

Practice Phone: 713-655-0073
Practice Fax: 713-655-1332

1811126162 — PIERRE PHYSICIAN GROUP P.A.
Practice Location Address:

1315 ST JOSEPH PKWY , SUITE 1503
HOUSTON, TX
77002-8233

Practice Phone: 713-655-0073
Practice Fax: 713-655-1332

1912988270 — WRINKLE'S PHARMACY, INC.
Practice Location Address:

5409 LAKE AVE
SAINT JOSEPH, MO
64504-1439

Practice Phone: 816-238-4522
Practice Fax:

Directions to “INTERFAITH COMMUNITY SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.